Australian Government Department of Health Medicare Benefits Schedule Book Category 4 Operating from 01 August 2014
OM.4.7. Aspiration of Haematoma - (Item 52056)
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- OM.4.9. Genioplasty - (Item 52378)
- OM.4.11. Skin Sensitivity Testing - (Item 53600)
- GROUP O1 - CONSULTATIONS
OM.4.7. Aspiration of Haematoma - (Item 52056)Aspiration of haematoma is indicated in clinical situations where incision may leave an unsightly scar or where access is difficult for conventional drainage. OM.4.8. Osteotomy of Jaw - (Items 52342 to 52375)The fee and benefit for these items include the various forms of internal or dental fixation, jaw immobilisation, the transposition of nerves and vessels and bone grafts taken from the same site. Bone grafts taken from a separate site, e.g. iliac crest, would attract additional benefit under Item 52318 or 52319 for the harvesting, plus item 52130 or 52131 for the grafting. Where the site of grafting under item 52131 requires closure by single stage local flap, item 52300 may be claimed where clinically appropriate. Clinically appropriate in this instance means that the flap is required to close defects because the defect cannot be closed directly. A local skin flap is an area of skin or subcutaneous tissue designed to be elevated from the skin adjoining a defect requiring closure. The flap remains partially attached by pedicle and is moved to the defect by rotation, advancement or transposition, or a combination of these manoeuvres. Benefits are only payable where the flap is required for adequate wound closure. A secondary defect will be created which may be closed by direct suture, skin grafting or sometimes a further local skin flap. This latter procedure will also attract benefit if closed by graft or flap repair but not been closed by direct suture. By definition, direct wound closure (e.g. by suture) does not constitute skin flap. Similarly, angled, curved or trapdoor incisions which are used for exposure and which are sutured back into the same position relative to the adjacent tissues are not skin flap repairs. Undermining of the edges of the wound prior to suturing is considered a normal part of wound closure and is not considered to skin flap repair. For the purposes of these items, a reference to maxilla includes the zygoma. OM.4.9. Genioplasty - (Item 52378)Genioplasty attracts benefit once only although a section is made on both sides of the symphysis of the mandible. OM.4.10. Fracture of Mandible or Maxilla - (Items 53400 to 53439)There are two maxillae in the skull and for the purpose of these items the mandible is regarded as comprising two bones. Hence a bilateral fracture of the mandible would be assessed as: Item 53409 x 1½; two maxillae and one side of the mandible as Item 53406 x 1½ + 53409 x ¼. Splinting in Item 53406 or 53409 refers to cap splints, arch bars, silver (cast metal) or acrylic splints. OM.4.11. Skin Sensitivity Testing - (Item 53600)The allergens are local anaesthetics and the contents of anaesthetic capsules, acrylic and other polymers and metals. OM.4.12. Destruction of Nerve Branch by Neurolytic Agent - (Item 53706)Item 53706 includes the use of botulinum toxin as a neurolytic agent. Schedules of Services Each professional service contained in the Schedule has been allocated a unique item number. Located with the item number and description for each service is the Schedule fee and Medicare benefit, together with a reference to an explanatory note relating to the item (if applicable). If the service attracts an anaesthetic, the word (Anaes.) appears following the description. Where an operation qualifies for the payment of benefits for an assistant, the relevant items are identified by the inclusion of the word (Assist.) in the item description. Medicare benefits are not payable for surgical assistance associated with procedures which have not been so identified. In some cases two levels of fees are applied to the same service in General Medical Services, with each level of fee being allocated a separate item number. The item identified by the letter "S" applies in the case where the procedure has been rendered by a recognised specialist in the practice of his or her specialty and the patient has been referred. The item identified by the letter "G" applies in any other circumstance. Higher rates of benefits are also provided for consultations by a recognised consultant physician where the patient has been referred by another medical practitioner or an approved dental practitioner (oral surgeons). Differential fees and benefits also apply to services listed in Category 5 (Diagnostic Imaging Services). The conditions relating to these services are set out in Category 5. Explanatory Notes Explanatory notes relating to the Medicare benefit arrangements and notes that have general application to services are located at the beginning of the schedule, while notes relating to specific items are located at the beginning of each Category. While there may be a reference following the description of an item to specific notes relating to that item, there may also be general notes relating to each Group of items.
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